Does fusion to T2 compared with T3/T4 lead to improved shoulder balance in adolescent idiopathic scoliosis with a double thoracic curve?

This study included 74 patients who underwent corrective surgery for Lenke-2 AIS with the right main thoracic and left proximal thoracic (PT) curve at a single center. Various radiological parameters were measured using whole-spine standing radiographs preoperatively and postoperatively. Patients were grouped by proximal fusion level: T2 (group F; fusion, N=15) or T3/T4 (group NF; nonfusion, N=59). Preoperative and postoperative radiological parameters were compared between the two groups. Group NF was divided on the basis of the existence of a postoperative shoulder imbalance (PSI;>15 mm) and a subgroup analysis was carried out. PT curve correction rate (58.5 vs. 46.3%, P=0.005), right shoulder depression (4.3 vs. 10.3 mm, P=0.020), and proximal adjacent wedging (1.1 vs. 3.5°, P
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: SPINE Source Type: research

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Conclusion. Anxiety and mood are potentially modifiable risk factors that have the greatest impact on pre- and postoperative pain. These results can be used to identify higher-risk patients and develop preoperative therapeutic protocols to improve postoperative outcomes. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
Publication date: November 2019Source: Spine Deformity, Volume 7, Issue 6Author(s): Jussi P. Repo, Ville T. Ponkilainen, Arja H. Häkkinen, Jari Ylinen, Paula Bergman, Kati KyröläAbstractStudy DesignObservational cohort study.ObjectivesTo measure and compare the structural validity of the Oswestry Disability Index (ODI) and the Scoliosis Research Society–30 (SRS-30) questionnaire in an adult population with prolonged degenerative thoracolumbar disease.Summary of Background DataThe ODI and the SRS-30 are commonly used patient-reported outcome instruments to assess back-specific disability and symptoms re...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
AbstractA 27-year-old man with severe pectus excavatum, dextrocardia and spinal scoliosis underwent thoracoscopic pleural decortication due to failure of 1-month medical treatment for tuberculous empyema. One month after the pleural decortication, he again underwent open thoracostomy window for repetitive pleuro-cutaneous fistula with tuberculosis empyema. He was subsequently referred to our clinic for progressive dyspnea and bilateral leg edema 4  months after the open thoracostomy window. Evaluations revealed deterioration of the chest wall depression and further compression of the inferior vena cava, which were con...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Background: Opioids are commonly used after posterior spinal instrumented fusion (PSIF) for adolescent idiopathic scoliosis (AIS). Prescription opioids use can potentially lead to misuse, abuse, dependence, and overdose death. Prolonged opioid use has not been extensively studied in the postoperative AIS population. The purpose of this study is to identify risk factors associated with prolonged opioid use after PSIF for AIS. Methods: A large insurance database was queried for AIS patients undergoing PSIF. Patients with prolonged postoperative opioid use were defined as those receiving new prescriptions for an opioid m...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scoliosis Source Type: research
by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Ano...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioid pain rosielle The profession Source Type: blogs
Publication date: Available online 3 August 2019Source: Journal of Pediatric Surgery Case ReportsAuthor(s): DeAsia D. Jacob, Rachel E. Aliotta, Neilendu Kundu, David K. Magnuson, Francis A. PapayAbstractCongenital diaphragmatic hernia (CDH) is an infrequent occurrence but can present a complex situation for physicians. The respiratory system can be affected in various ways. Primary closure often is not feasible and many autologous tissue, prosthetic and biosynthetic options exist to assist with closure. Many of the sequelae of this repair manifest later in childhood with revision being common for many reasons, most commonl...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
ConclusionsTo the best of our knowledge, this is the first study to explicitly model the prediction of individual answers to the SRS-22R questionnaire at 1 and 2  years after deformity surgery. The ability to predict individual question responses may prove useful in preoperative counseling in the age of individualized medicine.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
SPONASTRIME dysplasia is an autosomal-recessive spondyloepimetaphyseal dysplasia characterized by spine (spondylar) abnormalities, midface hypoplasia with a depressed nasal bridge, metaphyseal striations, and disproportionate short stature. Scoliosis, coxa vara, childhood cataracts, short dental roots, and hypogammaglobulinemia have also been reported in this disorder. Although an autosomal-recessive  inheritance pattern has been hypothesized, pathogenic variants in a specific gene have not been discovered in individuals with SPONASTRIME dysplasia.
Source: The American Journal of Human Genetics - Category: Genetics & Stem Cells Authors: Tags: Article Source Type: research
CONCLUSIONS: There is moderate- and low-quality evidence that there may be a small additional reduction in pain up to 72 hours after surgery with epidural analgesia compared with systemic analgesia. Two very small studies showed epidural analgesia with local anaesthetic alone may accelerate the return of gastrointestinal function. The safety of this technique in children undergoing thoraco-lumbar surgery is uncertain due to the very low-quality of the evidence. The study in 'Studies awaiting classification' may alter the conclusions of the review once assessed. PMID: 30650189 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Publication date: January 2019Source: Spine Deformity, Volume 7, Issue 1Author(s): David N. Bernstein, M. Owen Papuga, James O. Sanders, Paul T. Rubery, Emmanuel N. Menga, Addisu MesfinAbstractStudy DesignRetrospective cross-sectional cohort analysis.Objectives1) To assess the correlation of Patient-Reported Outcomes Management Information System (PROMIS) domains with SRS-22r/SRS-30 domains in all scoliosis patients; 2) to assess the correlation of PROMIS domains with SRS-30 domains in adult scoliosis patients; 3) to assess the correlation of PROMIS domains with SRS-22r/SRS-30 domains in pediatric scoliosis patients; and 4...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
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